broken clavicle - am I being paranoid?

about 2.5 weeks ago I broke my clavicle in an mtb otb incident. no experience of this, vicarious or personal, so didn't know what to expect. I was told it was fractured in 2 places but it would heal fine on it's own, with a lump in the bone where the break was. I took this to mean a hairline fracture and not a break.

today I had my first assessment since thw accident and saw the xray(from the day of the accident) for the first time. the bone is in twain! the ends overlap by about an inch! (apparently a 'displaced fracture'.) the doctor said he was 'very happy' with it. "an operation [to plate or pin it] would be useful in the case of a triathlete or someone who needs to regain full strength"!

I don't want to have a weak, short shoulder for the rest of my life and risk back problems through asymmetry, and I am more than a little upset that this displacement was not mentioned at the time and I was allowed to belive it was simply swelling.

I am told the window of opportunity for this operation is four weeks from the date of the accident. I am scheduled for the 'elective surgery' (rather than 'trauma surgery') next tuesday. that will be 3.5 weeks. I am worried because the nurse who rang me with the appointment repeatedly stressed 'provided that the pre-op team don't find a medical reason for you not to have the operation'.

also, the doc didn't seem to want me to have it. and he had three nurses in his tiny consultation room during my meeting with him (is that normal?).

I really hope I'm being paranoid and they're not going to try and find some reason not to operate...

Sounds pretty much identical to my break, I did mine in France and was strapped up and told to get on with it. Dr in the uk said surgery would just be additional risk with infection etc and I didn't fancy being part metal. Doesn't give me any bother apart from car seatbelts rubbing on the nubbin on long journeys. I'm sure they'll pin you up good though and you'll be fine.

Ok i broke my clavicle at the end of April and tbh the e-ray looked bad to me but never concerned the doctors at all. Its about 9 weeks since the accident and i'm still not 100% although it is getting stronger all the time. When i was signed off from the hospital on 20th June they said my bones were back up to about 80% strength and it would take another 4 - 8 weeks from then to reach 100%.

At the time that i did it, i considered surgery but was advised that the scarring that the op will leave would be very bad. For that reason alone I wouldn't have gone down that route!

Having said that, your situation might be slightly different if its broken in 2 places. If the doctors were happy with your condition, why are you having an op? Is it just to guarantee full strength?

DOn't worry they're not going to go through the hassle of scheduling it just to cancel it on the day because they've decided they're happy with how it's healing. A 'medical reason for you not to have the operation' would be they discover you're allergic to the anesthetic. Your doctor didn't want you to have the op because if you don't you'll still be 99% as good as new but if you do and get an infection it's really bad news

genuine thanks for the reassurance. I think I may be being ott. still want the op though to give the best outlook for the longterm (barring infections/dying under anaesthetic etc). I am worried about it being weaker or causing back probs. atm, if I left it I think I would be among the luckier ones as after just two weeks, I have the majority of my mobility, if very little strength.

keep thinking back to a broken femur 12 years ago, which was 'rodded' straight away. I was advised to not have the rod removed, but couldn't shake the fear of what would happen if I had a similar (motorbike) accident and the rod bent while still inside the femur. can't imagine how that could be fixed without dismantling the bone or removing the leg.

my point is, I understand the doc doesn't want to recommend a procedure that isn't 100% critical, but the risks/benefits I am weighing up are different to his.

I broke my left collar bone in 3 pieces 7 years ago. It wasnt plated but left to heal naturally and have a similar looking lump as the one pictured above. I'm a carpenter and as such am lifting heavy beams and all sorts most of the time. I dont have any problem with stregth in the bone or any twisting of the body. One arm is slightly shorter than the other but I've never found that to be a problem anywhere in live!

Mine sounds very similar to yours OP - although I couldn't actually read the details - some 7 years on it still makes me wince at the thought.

Mine was a clean solid break in the middle that hadn't fused, some 8-10 weeks later. I got put on a 6 week waiting list for an op for a clavicle plate. Then spent about 3 weeks recovering from that. So all in, about 5 months out of action!

NHS delays notwithstanding, the operation was the best thing. The collar bone's never been a problem since and I recuperated my shoulder by taking up swimming (something I sill do regularly 7 years on). I am also part titanium

Okayee edit (I have now managed to read the OPs post): Didn't realised that yours had fused. It will probably be fine, from what I've heard anecdotally, although TBH I was actually quite 'pleased' in the end when I found out mine wasn't healing..

Broke mine 2 years ago and I didn't have it operated on even though I snapped the end clean of and it fractured upwards in the middle.

I was really paranoid about regaining full mobility of my shoulder. Eventually I spoke to the shoulder specialist at the hospital and he said that I shouldn't have a problem with lifting weights or climbing.

Due to the way it broke, my collar bone is slightly shorted and my scapular is twisted, but it is strong and I only notice it when it is cold or after long car journeys.

I think you will be fine, if they have scheduled the operation, no reason to think they won't go through with it.

The clavicle is such an annoying bone! So many different ways for it to break and heal, and so unprotected that it's easy to do.

I say this because I'm healing up from doing mine too. As far as I can tell, no separation happened in mine, and certainly no doctors interested in doing surgery on it. But all the advice I've had (two doctors and a physio) is to keep it immobile as possible in the sling, so now I'm almost five weeks in and getting a bit fed up of it. Meanwhile online I see all sorts of advice about getting it moving with pendulum exercises and stuff.

I'm no doc, but I'd hurry and get it plated, sounds like they don't want to operate because the overlapping bone is already uniting, mine was in three pieces and spread apart, the main bone almost compound so mine was a trauma op, I went private on the company policy, right as rain now.

I broke my RH clavicle in a similar OTB fashion when I was 24. Being right handed I thought my Rugby days were over. However, they gave me the option of a plate but I decided not to following advise from my rugby club physios. So....other than a 6 - 8 week recovery period building the muscle up around the shoulder I then got back to playing club rugby at a reasonably high level as an inside (crash ball) centre for another 6 years with no ill effects. The best way to protect a joint / bone is to build muscle round it....oh, and drink lots of milk!

I broke mine last year. mine was only broken in one place, mid shaft and there was a lot of over lap too but mine was a clean break it was shattered into lots of pieces.

At my first fracture clinic appointment the doc gave me the choice of surgery or not. Saying he thought case could be made either way but he thought it would heal fine without surgery.

I wasn't happy about the fact I had to make the call so I contacted a few other surgeons and upper limb specialists to get more information. They all said because I was an active person they would recommend surgery as I would get back on my feet a little quicker. But had I not been an active person a natural healing process would be recommended. The old trends with doctors was to operate almost all the time. But recent trends are to allow the clavicle to heal by it self, patients have little or no mobility issues and the strength is as normal. The overlap may look large but it will be reduced as it heals.

If you are booked in for an op then chances are it will go ahead. They will only cancel it if you are found to have a medical condition or allergy or if by some miracle the bone is showing vast accelerated healing negating the need for the op.

Good luck I'm sure you'll be fine. Hope you're back on the bike soon. And listen to the docs, if they don't move it, then .. don't move it!

I broke my right clavicle leaving a step as it overlapped by an inch, this was 26 years ago. I've had no strength problems, but I now notice that my head is slightly to one side in photo's. I recently went to have a full 360 degree x ray for teeth, the nurse was constantly moving my head straight when I thought it was. I have monthly osteo treatments for my neck to loosen up and keep my head straight. I know when it is due as I think the peak on my helmet is wonky, try to adjust it and realise it's me.

Not quite the same injury(so this could be complete useless to you!), but I separated my shoulder. For those who don't know this is breaking the ligaments that hold the clavicle to the scapula so you end up with simliar situation of the bone sticking up and not being properly connected. My shoulder felt weak and floppy and the doctor gave me similar advise (don't operate unless you're an Olympic javelin thrower!). I had the same reaction as you and went for a second opinion who said the same as the first doc so I decided to trust them.

That was a year ago, I regained full use of the shoulder pretty quickly (3 months-ish and I was back on the bike) and now I am lifting heavier weights at the gym than I ever have. It does sometimes ache, and it doesn't enjoy full tricep-dips very much, but I can't imagination a screw in my shoulder would be completely trouble free either.

I’m now on my second broken clavicle. 7 weeks into healing from breaking my right, after breaking my left 3 years ago.

In both cases they looked pretty fkd on the x-ray with displacement and overlap.

I now have symmetrical lumps and narrower by about 75mm on both sides.
I was offered surgery this time round but as my left healed fine with no loss of movement or strength and this one looked almost identical on the x-ray to last time along with Dr’s advices, I opted for the natural approach.

The first four weeks seem to drag by with very little progress, but then all of a sudden they start to get strong and then every day it just gets better.

I have an appointment in two weeks and all being well that should that. However last time I had a four week appointment and was then told to be careful for another 4 weeks, then assume will be ok. No follow up appointment! Mine now feels pretty good so I’m back to riding again (nothing too crazy just yet though)

I now consider myself an expert on collar bone breaks as I have read everything the internet has to offer on the subject twice over. Both times I have consumed unhealthy doses of calcium, cod liver oil (for Vit D) and glycosamine. In summary:

1) Surgery or natural method they take a while to heal and it can be a bit depressing especially when it’s biking weather, but soon enough you will be back to normal

2) Doctors are vague and seem to guarantee nothing, but trust them all the same, they see this all the time. Some say it is the most common break and 95% are said to heal fine naturally.

I'm not an orthopaedic surgeon but I am a doc who regularly anaesthetises for shoulder surgery. The management of clavicle fractures is controversial, even amongst surgeons. Most do not need surgery and will heal perfectly well with immobilisation - even if there is some overlap. Surgery is usually indicated if there is a significant overlap or such severe 'tenting' of the skin that it's causing damage. Otherwise it's not clear. Surgery probably speeds up recovery and probably gets the strength back quicker. How important that is for a non-professional sports person I don't know. The downside is the risks of surgery. These are pretty slim if you are fit and healthy but anytime you put metalwork in the big risk is infection, which can range from very minor to do severe the metalwork has to be removed. Again this is rare but not unknown.
This is why the surgeon wants to be certain that you definitely want the op. it's not like some fractures that need to be fixed ASAP and its pretty specialised surgery which is why you're on a dedicated op list. The nurse is saying what they say to everyone at pre-op so there are no cancelations or surprises on the day. If you're fit and healthy with no major allergies there shouldn't be a problem. As an aside smoking is a big no no with healing any fracture and is a risk for infection if there's metalwork.

Hope this helps. Remember I'm not a surgeon or your doctor so this isn't formal advice. Ultimately neither approach is wrong and I suspect your surgeon wants to make sure you know the risks and benefits of both.

I had a displaced fracture (by about an inch) to my collarbone in May 2011. Being a sponsored rider I was desperate to get on back on the bike ASAP. The consultant said I was right on the borderline of plating it or not: and although they preferred not to plate it, they would do so if I insisted. After taking a second opinion and the collective wisdom of my coach and numerous other riders I let it heal naturally. I didn’t want a plate remaining in there if I was to fall on it again (likely) and I didn’t want the time out of riding at a later date to have it removed.

It took 12 weeks before I was confident in its strength to get back on the road bike (but that was a road trip to the Pyrenees), and 4 months before I was back on the mtb properly – much longer than I had hoped for.

However, after following good physio advice and really working hard at my rehab it did eventually heal well, and I came back a much stronger rider. Within a year I podiumed at a national 24hr solo, with no ill effects.

I still have a lump in the collarbone similar to WackoAK, but other than having to occasionally rearrange a camelback strap I don’t notice it at all.

If you provide your body with the best conditions for it to heal itself by resting, getting plenty of sleep, eating healthily, taking supplements (such as calcium, potassium and vit C & D), and not doing too much on it too soon you should recover well whichever option you choose. Recovery isn’t a competition. Everyone heals at different rates, so try not to get too hung up about expected recovery time from other’s experiences, your body will tell you when you are ready to ride again if you just listen to it.

Fitness can be maintained well on a turbo trainer, and will give you a hunger to ride a proper bike when you are able to do so again.

Be realistic, keep positive, and you should be back riding better, faster, stronger than before.

hallz, I lived next to the 'flowers' estate in Farnworth for a couple of years about 8 years ago (practically on the doorstep of Bolton Royal for those who don't know). in darwen now and they're sending me to Burnley for the op.

I did ask about risk of infection and what they thought of the bad press Bolton got. the nurses don't seem too upset by the 'revelations'. seems it is a statistical inevitability that Bolton will come off bad on paper because of the nature and volume of their intake. and the waiting times for trauma victims because they are picking up the slack due to closures elsewhere.

anyway, I am reassured that the likelihood of infection is minimal during the procedure and that the 'danger zone' is post-op, when a large part of the risk is dependant on me taking appropriate measures to protect myself. also, given I am generally robust and in good shape, my risk is fairly small. and credit to the nurses for not taking any offense at my bumbling enquiries ("having an operation - will I die?").

As others have said the clavicle normally heals very well without intervention (I've broken mine three times so I should know). I don't want to add to your worries but there major nerves in that area which is why my wife elected not to have surgery on hers when she dislocated it and she is an orthopaedic surgeon.

thank owen - it is something to think about. the surgeon doing my procedure is very experienced and tutors trainee surgeons, so I'm hopeful that I'm in good hands; I acknowledge that there's no such thing as a sure thing though.

Did mine two years ago...plated after two weeks as it wasn't knitting (the older you are the less chance of it not knitting)
Like Lugz i have the odd chafing moment, and I can feel the screw heads etc. I took a pic of the PC screen when the Consultant showed me his handywork

oh as owen7 states, i have a numb area around my shoulder as they cut through some nerves, not a biggie and it was discussed prior

You're not being irrational. I did exactly when I cased some trails on a bmx. I had to then drive about 60 miles to the hospital (where my other half works) - the doctor said he wanted to leave it. Then I saw the x-rays (like yourself) and I pretty much insisted on an operation to put it right - for similar reasons, that I wanted the full strength back.

The operation was quick, but the healing process took a while, and my shoulder was numb (cut through nerves) for months after. I'm glad I had the op as it's back to 100% strength - the only niggle is when I have a rucksack on and the straps rub on the screws under my skin. It has a sharp, shooting pain.

Operations are obviously more expensive than letting it heal naturally so the docs would rather take that approach, and to avoid any possible complications arising from an op. But, if you're an active person, don't take the risk of it healing badly and get the op.